Provider Demographics
NPI:1841479722
Name:JASMINE KIM INC
Entity type:Organization
Organization Name:JASMINE KIM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-273-5555
Mailing Address - Street 1:5938 ASHWORTH RD
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7110
Mailing Address - Country:US
Mailing Address - Phone:515-273-5555
Mailing Address - Fax:515-273-5556
Practice Address - Street 1:5938 ASHWORTH RD
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7110
Practice Address - Country:US
Practice Address - Phone:515-273-5555
Practice Address - Fax:515-273-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA6312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6312OtherIOWA
IA1214254Medicaid
IAU62149Medicare UPIN